HARRISBURG, Pa. (AP) -- Gov. Tom Corbett will begin the formal process Friday of seeking approval for his plan to bring billions of federal Medicaid expansion dollars to Pennsylvania to extend health insurance to half a million working poor.
The process will begin with the online posting of Corbett's approximately 100-page proposal, which lays out more detail surrounding his plan to use the expansion money to help people buy private insurance, rather than cover them under the traditional Medicaid program.
The process will begin with the online posting of Corbett's proposal, an approximately 100-page document that lays out more detail surrounding his plan to use the expansion money to help people buy private insurance, rather than cover them under the traditional Medicaid program.
The administration also will announce six hearings on the proposal around Pennsylvania — in Philadelphia, Pittsburgh, Altoona, Harrisburg, Erie and Scranton — plus two online seminars and a public comment period lasting through Jan. 13 before it submits it to the federal government, possibly in February.
Under President Barack Obama's signature health care law, the federal government promises to foot the lion's share of the bill for any state that broadens its Medicaid eligibility guidelines to cover more low-income adults. The Medicaid expansion is a key element of the law's goal of providing health insurance to tens of millions more Americans.
The federal Medicaid expansion dollars become available Jan. 1 and there is heavy in-state pressure on Corbett to embrace a Medicaid expansion from groups including the AARP, labor unions, advocates for the poor, hospital and doctors' groups and even the Republican-controlled state Senate.
However, Corbett, a Republican and a critic of Medicaid who opposed the law as Pennsylvania's attorney general, is packaging his Medicaid proposal with a number of conditions that he says make it a better and more affordable way of providing health insurance.
It is not yet clear whether the Obama administration will agree to Corbett's conditions, whether Corbett will be willing to compromise on any of them or how long past Jan. 1 it will take to come to an agreement.
Fabien Levy, a spokesman for the U.S. Department of Health and Human Services, said the agency looks forward to receiving the Corbett administration's proposal and is willing to be as flexible as it can with the approach.
A key element of Corbett's proposal is to use the expansion money for private insurance plans, a concept the federal government approved in Arkansas, rather than expanding traditional Medicaid coverage. Corbett will have to persuade the federal government his plan to buy private insurance will cost the same amount of money, or less, than an expansion of Medicaid, which tends to be cheaper because it typically pays doctors and hospitals less for care than do private insurers.
In addition, Corbett wants to pare back Medicaid benefits for any able-bodied adults under 65, eliminate all co-pays but one in favor of a new premium structure and require the able-bodied who are working 20 hours or less to meet certain work-search goals, including engaging in 12 job-searching activities each month. The requirement would affect about 5 percent of the people who are newly eligible for Medicaid expansion in Pennsylvania, Corbett administration officials say, but health care advocates say federal law prohibits such a requirement from determining Medicaid eligibility.
Twenty-six states, including Washington, D.C., now plan a Medicaid expansion of one sort or another, including some states run by Corbett's fellow Republican governors and every single state that neighbors Pennsylvania. Seven states, including Pennsylvania, are considering it.
Under the Medicaid expansion that the law envisions, many adults with incomes of up to 138 percent of the federal poverty level, or about $32,000 annually for a family of four, will become newly eligible for the coverage.